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1.
Lynda M. Baker 《Journal of the Medical Library Association》2004,92(1):78-82
During the last phase of life, a person may need a variety of information to help her or him cope with dying and death. This article describes the nature of information needed during this stage. A content analysis was done of a book of conversations between a husband who was dying and his wife who is a grief counselor to determine his information needs. Four categories of needs were proposed, including physical, emotional, spiritual, and financial. Information needs germane to each category were identified. More research needs to be done by library and information science professionals to determine the information needs of people who are dying, as well as those of their families and the health professionals who care for them.Death happens in one of four ways. For some people, it arrives suddenly, thus robbing them of the luxury of preparing themselves or their families for this event. For other people, death comes from frailty (e.g., old age, dementia); terminal illness (e.g., cancer, amyotrophic lateral sclerosis); or organ system failure (e.g., chronic obstructive pulmonary disease) [1]. This slower entrance into the end-of-life phase allows people time to seek information. However, library and information science (LIS) professionals have done very little research on the information needs and information-seeking behavior of people at the end of life. In this article, the author describes a process used to determine the information needs of one person as he passed through the final phase of his life. 相似文献
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Judith Messerle 《Journal of the Medical Library Association》2001,89(1):1-7
The annual Janet Doe Lecture was established in l966 to honor Janet Doe, emerita librarian of the New York Academy of Medicine. The lecture focuses on either the history or philosophy of health sciences librarianship. This lecture addresses three fundamental values of the field, highlighting basic beliefs of the profession that are at risk: privacy, intellectual property rights, and access to quality information. It calls upon readers to make the everyday choices required to keep the value system of health sciences librarianship in place. Robert Frost''s poignant poem ”The Road Not Taken” provides the metaphor for examining choices in an information economy.
Two roads diverged in a yellow wood,These charming pastoral words evoke a not so subtle hint at the importance of choices made and opportunities unexplored. When Frost wrote these words in Vermont more than a century ago, he had no intimation of the myriad choices that overwhelm our senses today. The rhythm of the crafted stone fences of New England marked the boundaries of the land. The disruption of the interstate highway with its unrelenting straight lines had not yet cleaved the fences one from another. The stillness of the woods was not yet pierced by jet-propelled aircraft and, yet, Robert Frost knew then of roads not taken.
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,
And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
Robert Frost [1]
“And I shall be telling this with a sighWe, too, know of choices forced upon us with dizzying pace, choices made with adrenaline and exhilaration, agonizingly belabored, or often ignored. Choices surrounding our fundamental beliefs in an age of disruptive technologies and value-changing economies are the theme of this paper. Walk down a path with me that examines choices around privacy, intellectual property rights, and access to quality information, core values that medical librarians support and rely upon every day of the year. 相似文献
Somewhere ages and ages hence”
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Evidence-Based Medicine Reviews (EBMR) is a new full-text product from Ovid Technologies. EBMR supports the practice of evidence-based medicine (EBM) by providing access to two premiere EBM resources: the Cochrane Database of Systematic Reviews from the international Cochrane Collaboration, and Best Evidence from the American College of Physicians-American Society of Internal Medicine. Both resources alert health care professionals, researchers, and librarians to clinically relevant and methodologically sound studies by providing access to full-text reviews and meta-analyses of clinical literature. Value-added features include links to EBMR from MEDLINE, alerting MEDLINE users to available reviews. An "EBM Reviews" limit within MEDLINE facilitates access to the EBMR database contents. 相似文献
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Jonathan D. Eldredge Laura J. Hall Karen R. McElfresh Teddy D. Warner Tiffany L. Stromberg Jaren Trost Devin A. Jelinek 《Journal of the Medical Library Association》2016,104(1):33-41
Objective
The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.Methods
In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants'' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen''s d statistic to compare pre- and post-study effects sizes.Results
Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen''s d increase of +1.50 compared to AccessMedicine users'' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen''s d.Conclusion
Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine.Keywords and Medical Subject Headings (MeSH) Clinical Decision Support Systems, Computer-Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide, Information-Seeking Behavior, Medically Underserved Area, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Public Health Nurses, Randomized Controlled Trial as Topic, Service Learning, Vulnerable PopulationsHealth care practitioners regularly seek to incorporate valid information into their evidence-based decisions. Electronic information resources now provide easy access to current health information and summarized forms of evidence to support clinical decision making.Access effects on health care
Health care providers who are affiliated with well-funded institutions benefit from access to a variety of high-quality information resources to support their evidence-based practices. Practitioners who are not affiliated with academic health sciences centers rarely have access to these same resources due to prohibitively high licensing costs. Ely et al. report that not having access to easy-to-use, high-quality, current information can negatively affect sound clinical decision making. [1].Patients in Isaac et al.''s study who were admitted to hospitals that had access to an electronic evidence-based resource experienced reduced length of stay and lower risk-adjusted mortality rates for prespecified conditions [2]. That study was validated on a broader scale by a multicenter investigation on the utilization of information resources by practitioners [3].Primary health care practitioners who are not affiliated with academic health sciences centers, particularly those who practice in rural or remote areas, often articulate the need for increased access to health information resources. The authors'' literature search and review of 114 of the most relevant research articles about the information needs and information-seeking behavior of health care practitioners suggested that these professionals most value speed and accuracy. For example, they likely would prefer to use point-of-care (PoC) resources for quickly and accurately answering their clinical questions.Desirability of point of care
PoC resources quickly guide physicians through the diagnosis, treatment, and management of commonly encountered clinical conditions. PoC resources can present compilations of highly authoritative, often evidence-based, information. Physicians can answer more questions and revise clinical decisions more often using these PoC resources [4]. Meanwhile, many health care practitioners still rely on textbooks familiar to them from their professional training programs, despite their potentially dated contents [5–14].Limited access in rural New Mexico
A randomized controlled trial involving public health practitioners across the rural state of New Mexico reported many barriers in accessing valued information resources [15, 16]. In another study, researchers in New Mexico set out to determine and analyze information needs of health care practitioners who were not affiliated with an academic center. Fifty-one interviews of rural physicians, nurses, physician assistants, and nurse practitioners showed both a need and desire for access to information resources [17].Goals and hypothesis
This study sought to determine which rural health care providers found more useful in answering everyday clinical questions: electronic PoC DynaMed, which is more clinically oriented, or electronic PoC AccessMedicine, which consists primarily of a health sciences textbook collection. We hypothesized that free access to the explicitly clinical format of the PoC resource DynaMed would result in more extensive use than a baseline of zero over a six-month period than the electronic PoC textbook collection AccessMedicine. We felt this would be due to greater utility of DynaMed in clinical practice. We also predicted that clinicians using the clinically oriented PoC would express higher levels of satisfaction than those using the textbook-based PoC and that clinicians using these PoC resources would prefer using them over other information resources. 相似文献6.
K H Smith 《Medical reference services quarterly》2001,20(3):13-21
Health InfoNet of Jefferson County is a new collaborative consumer health information service of the Jefferson County public libraries and the UAB Lister Hill Library of the Health Sciences. Working with the input and cooperation of local voluntary health agencies, health care professionals and other health information providers, the intent is to improve the efficiency with which consumers might access such information while avoiding duplication of effort on the part of the information providers. Various considerations in InfoNet's mission include providing service not only to established library and Internet users, but also those on the other side of the "digital divide" as well as those with low literacy skills or English as a second language. The role of health care professionals in guiding their patients to the best consumer health information resources is emphasized. 相似文献
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Jean P. Shipman Sabrina Kurtz-Rossi Carla J. Funk 《Journal of the Medical Library Association》2009,97(4):293-301
Objectives:
This research studied hospital administrators'' and hospital-based health care providers'' (collectively, the target group) perceived value of consumer health information resources and of librarians'' roles in promoting health information literacy in their institutions.Methods:
A web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group.Results:
A majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions'' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support.Conclusions:
It is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources.Highlights
- Health care providers responded positively to a health information literacy curriculum offered by librarians and to related resources and services, namely MedlinePlus and the information referral system known as Information Rx.
- Participation in a curriculum increased health care providers'' knowledge of health information literacy, awareness of available consumer health information, and referral of patients to the library for additional assistance.
- Librarian involvement in health information literacy increased the profession''s visibility and perceived value.
Implications
- Consumer health information services and resources offered by librarians can improve the health information literacy skills of health care providers and their patients.
- Training by librarians can increase knowledge of the importance of health information literacy and usage of MedlinePlus and Information Rxs.
- Hospital-based administrators and health care providers can be champions in support of health information literacy and consumer health information services offered by libraries.
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Alexander J. Carroll Nedelina Tchangalova Eileen G. Harrington 《Journal of the Medical Library Association》2016,104(2):125-130
Objective
This study sought to determine whether a flipped classroom that facilitated peer learning would improve undergraduate health sciences students'' abilities to find, evaluate, and use appropriate evidence for research assignments.Methods
Students completed online modules in a learning management system, with librarians facilitating subsequent student-directed, in-person sessions. Mixed methods assessment was used to evaluate program outcomes.Results
Students learned information literacy concepts but did not consistently apply them in research assignments. Faculty interviews revealed strengthened partnerships between librarians and teaching faculty.Conclusion
This pedagogy shows promise for implementing and evaluating a successful flipped information literacy program.Keywords (Medical Subject Headings) Information Literacy, Educational Technology, Education, Distance/Methods, Teaching/Methods, Evidence-Based Practice/Education, Learning, Group Processes, Program Development, Humans, Libraries, Medical/EducationIn the short term, health sciences students utilize the information resources that librarians highlight during instruction. In the years after graduation, students demonstrate low levels of information literacy skills [1–3]. These low levels of retention likely result from the limited amount of time dedicated to guided practice during library sessions, which has been shown to be critical to learning [4]. In addition, few undergraduate curricula feature scaffolded instruction on evidence-based practice, where guidance of student learning is deployed progressively to promote stronger understanding of concepts. This raises the concern that many students may be unprepared for the rigors and expectations of graduate-level research. Consequently, health sciences librarians and educators have tested numerous methods for improving the effectiveness of information literacy and evidence-based practice instruction [5–7].Higher education has also seen a rise in the use of instructional technologies, such as increased use of video tutorials, web-conferencing tools, and learning management systems (LMSs). Such tools can enhance the effectiveness of face-to-face teaching by delivering time-of-need instruction that is available for future reference during the entire semester [8–11]. LMSs, such as Canvas or Blackboard, provide a virtual space where students take ownership of the learning process and create meaningful learning experiences for themselves and their peer learners [12]. Educators increasingly use these technologies to enable a flipped classroom model of instruction, in which the lecture and homework are reversed [13–15]. In older teaching models, a lecture occurs in the classroom, followed by exercises and applications of the information by students as homework. In the flipped model, students get the lecture-type information at home, then do exercises and applications in the classroom. This model allows instructors to move away from the traditional one-time lecture-based instruction and to incorporate active learning, which leads to better student performance for science, technology, engineering, and mathematics (STEM) undergraduate students [16–18]. The flipped classroom model also accommodates the needs of diverse populations of learners by integrating peer learning and assessment [19, 20]. In contrast, traditional lecture-based approaches to information literacy have been shown to have limited effectiveness for promoting skill development and retention, and often rely on shallow, quantitative assessments to measure student learning [21]. Integrating library instruction strategically into the curriculum and using the flipped classroom model creates opportunities to use a greater variety of assessment tools at various points throughout the semester in order to conduct more meaningful assessment of student learning.Flipped classroom models have not been widely studied for health sciences students. This study aimed to determine whether a flipped classroom approach for upper-level undergraduate students in the health sciences would improve their abilities to find, evaluate, and utilize appropriate evidence for research assignments. 相似文献12.
Carol E. Vreeland Kristine M. Alpi Caitlin A. Pike Elisabeth E. Whitman Suzanne Kennedy-Stoskopf 《Journal of the Medical Library Association》2016,104(2):100-108
Objective
“One Health” is an interdisciplinary approach to evaluating and managing the health and well-being of humans, animals, and the environments they share that relies on knowledge from the domains of human health, animal health, and the environmental sciences. The authors'' objective was to evaluate the extent of open access (OA) to journal articles in a sample of literature from these domains. We hypothesized that OA to articles in human health or environmental journals was greater than access to animal health literature.Methods
A One Health seminar series provided fifteen topics. One librarian translated each topic into a search strategy and searched four databases for articles from 2011 to 2012. Two independent investigators assigned each article to human health, the environment, animal health, all, other, or combined categories. Article and journal-level OA were determined. Each journal was also assigned a subject category and its indexing evaluated.Results
Searches retrieved 2,651 unique articles from 1,138 journals; 1,919 (72%) articles came from 406 journals that contributed more than 1 article. Seventy-seven (7%) journals dealt with all 3 One Health domains; the remaining journals represented human health 487 (43%), environment 172 (15%), animal health 141 (12%), and other/combined categories 261 (23%). The proportion of OA journals in animal health (40%) differed significantly from journals categorized as human (28%), environment (28%), and more than 1 category (29%). The proportion of OA for articles by subject categories ranged from 25%–34%; only the difference between human (34%) and environment (25%) was significant.Conclusions
OA to human health literature is more comparable to animal health than hypothesized. Environmental journals had less OA than anticipated.Keywords (Medical Subject Headings) Publishing, Periodicals as Topic, Access to Information, Veterinary Medicine, Environment, Environmental Health, Medicine“One Health” is an integrated, transdisciplinary approach to solve complex problems at the diverse interfaces shared by humans, animals, and the environment [1]. The One Health approach to evaluating and managing the health and well-being of humans, animals, and the environments that they share relies on knowledge from the domains of human health, animal health, and the environmental sciences. Although there is a growing body of literature about the development of the One Health concept as documented by Pepper, Carrigan, Shurtz, and Foster [2], this literature is not the same as the combination of literature from the three domains that is applied in service of One Health. Every discipline related to One Health has its unique mindset and language, with corresponding lists of acronyms that are frequently an impediment to effective communication across the participating professions. Relevant papers guiding a One Health approach may never specifically use “One Health” as a term or concept.To promote better communication and collaboration among health professionals and environmental scientists, a public monthly One Health Intellectual Exchange Group (IEG) hosted by the North Carolina Biotechnology Center was launched in 2009. In 2011, faculty from the North Carolina State University College of Veterinary Medicine, University of North Carolina''s Gillings School for Global Public Health, Duke Global Health Institute, and Nicholas School of the Environment at Duke University expanded the IEG series into a weekly seminar course with eight One Health focus areas [3]. The eight focus area modules were the following: an introduction to One Health; environmental health and ecology; the human and animal bond; zoonoses and emerging infectious diseases; food and water safety; disease surveillance, informatics, and disaster preparedness; benefits of comparative medicine; and policy and education (Appendix A, online only). Each seminar speaker recommended papers to read prior to the session to provide a foundation for the topic because student backgrounds and majors were quite diverse. Represented student majors included master''s of public health, master''s of animal science, doctor of veterinary medicine, graduate-level environmental sciences, and undergraduate-level biochemistry, engineering, and biology.Open access (OA) to relevant literature is very important to scholars and practitioners working on interdisciplinary problems. The One Health Proof of Concept Workgroup found that few studies assess outcomes in human, animal, and environmental spheres simultaneously [4], making it important to be able to access articles from each of the three domains to get a more complete picture.The objective of this study was to evaluate the extent of OA to journal articles in a sample of literature relevant to One Health from the human, animal, and environmental domains. Working in a college of veterinary medicine and supporting faculty, staff, and students addressing interdisciplinary problems under the One Health umbrella [5], the authors were familiar with the extent of OA in human biomedical and public health literature and the literature of veterinary medicine but were less familiar with environmental journals. In light of general availability of environmental information and OA to publications such as Environmental Health Perspectives, we thought it likely that environmental literature would be relatively open compared to the other subject areas. Therefore, we hypothesized OA to articles from human health or environmental journals was greater than access to animal health literature. We chose to look at article-level subject categorization and access, as well as journal-level categorization and access, because they might differ. Article-level access relates more to authors'' decisions about OA for a content domain, while journal-level access and subject categorization are driven by publishers and associations. Understanding the distinction and having data would inform our efforts to promote increased OA to this literature. 相似文献13.
《Medical reference services quarterly》2013,32(2):41-56
Holistic medicine and therapeutic systems are increasingly popular health care alternatives. Reference librarians, when asked about subjects pertaining to the vast field of holistic health, have found the bibliographic resources to be obscure, confusing, and inconsistent. The first two sections of this article discuss the subject access that is provided by Library of Congress and National Library of Medicine subject headings. In the final section there is an annotated bibliography of the chief reference sources for the field. Reference librarians are encouraged to work through the difficulties of finding answers in this field and to treat such queries as typical consumer health care questions. 相似文献
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MEDLINEplus: building and maintaining the National Library of Medicine's consumer health Web service 总被引：1，自引：0，他引：1
MEDLINEplus is a Web-based consumer health information resource, made available by the National Library of Medicine (NLM). MEDLINEplus has been designed to provide consumers with a well-organized, selective Web site facilitating access to reliable full-text health information. In addition to full-text resources, MEDLINEplus directs consumers to dictionaries, organizations, directories, libraries, and clearinghouses for answers to health questions. For each health topic, MEDLINEplus includes a preformulated MEDLINE search created by librarians. The site has been designed to match consumer language to medical terminology. NLM has used advances in database and Web technologies to build and maintain MEDLINEplus, allowing health sciences librarians to contribute remotely to the resource. This article describes the development and implementation of MEDLINEplus, its supporting technology, and plans for future development. 相似文献
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Calabretta N 《Medical reference services quarterly》1996,15(3):13-22
The health care environment of the 1990s demands that hospital libraries develop creative strategies for providing consumer health information (CHI). Librarians at the Reuben L. Sharp Health Sciences Library at Cooper Hospital/University Medical Center have developed a multifaceted approach to the problem. Using a combination of institutional resources, private funding, and cooperative arrangements with public libraries, the Sharp Library helps to serve the consumer health information needs of the southern New Jersey community. 相似文献
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Katie A. Ports Antoinette Ayers Wayne Crocker Alton Hart Maghboeba Mosavel Carlin Rafie 《Journal of the Medical Library Association》2015,103(1):35-39
The purpose of this study was to understand factors that may affect the usage of a consumer health center located in a public library. More specifically, the authors wanted to know what health resources are of interest to the community, what patrons'' perceptions of their experience at the center are, and finally, how staff can increase utilization of the center. In general, perceptions of the center were positive. The findings support that participants appreciate efforts to provide health information in the public library setting and that utilization could be improved through marketing and outreach.Problems with health literacy—one''s ability to obtain, process, and understand basic information and services needed to make appropriate health decisions 1, 2—significantly limit effective dissemination and understanding of relevant health information, especially among racial and ethnic minorities where health literacy challenges are pervasive 3–5. People with limited health literacy skills have higher medical costs and use an inefficient mix of medical services 3, 6–13. This compromises their health and is a major source of economic inefficiency in the US health care system. Efforts to address low health literacy may result in reductions of health inequities, decreased medical costs, and enhanced quality of life 14. However, efforts to promote health literacy that seek to empower individuals to understand health information and act in their own interest remain an underexplored pathway to improved health outcomes 9.The National Network of Libraries of Medicine (NN/LM) encourages libraries to reach out to low literacy groups in their surrounding communities to address literacy challenges 15–17. These actions have resulted in development of consumer health libraries, centers where patrons can get accurate and timely health information. Preliminary investigations of consumer health libraries have reinforced the value of these services 18, 19, but there is little information regarding the provision of similar services in other public settings.The Healthy Living and Learning Center (HLLC), located in a public library in Petersburg, Virginia, was established in 2012 to provide one-on-one assistance in accessing health information and community resources. According to 2010–2013 census data, 25% of Petersburg residents are below the poverty line 20. Localities surrounding the HLLC experience some of the most unfavorable health outcomes in Virginia 21. In addition, 16%–24% of citizens in the surrounding localities are illiterate 22.The public library setting provides an appropriate context to initiate consumer health centers outside of medical settings. Librarians are already being asked to meet consumer demands for health information 15–17, and the provision of accurate health information is a natural extension of the services that public libraries provide. The American Library Association reports that 62% of libraries report that they are the only source of free public access to computers and the Internet in their communities 23. According to a recent study from Pew, 35% of Americans 16 and older say they have used free Internet access points, 47% of whom have used these services to get health information 24. For a number of minorities, the public library is the only place they have Internet access 25. Thus, libraries not only remain a critical resource among the public, but may also have unique access to populations who are more vulnerable to health inequities. 相似文献
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Ana D Cleveland 《Journal of the Medical Library Association》2011,99(1):61-69
Purpose:
This lecture discusses a philosophy of educating health information professionals in a rapidly changing health care and information environment.Discussion:
Education for health information professionals must be based upon a solid foundation of the changing paradigms and trends in health care and health information, as well as technological advances, to produce a well-prepared information workforce to meet the demands of health-related environments. Educational programs should begin with the core principles of library and information sciences and expand in interdisciplinary collaborations. A model of the health care environment is presented to serve as a framework for developing educational programs for health information professionals.Conclusion:
Interdisciplinary and collaborative relationships—which merge health care, library and information sciences, and other information-related disciplines—should form the basis of education for health information professionals.Highlights
- Educational pathways for the creation of future health information professionals are charted through the discussion of four major roads.
- A model of the health care environment sets the framework for building educational programs for health information professionals.
Implications
- The presented pathways can inform educational decision making at all levels, including the need to revisit the accreditation bodies of programs educating health information professionals.
- The National Library of Medicine is encouraged to create a workforce center to identify the needs of the profession.
- Interdisciplinary and collaborative partnerships are vital to produce quality graduates who are prepared to handle the complexities of the health care and information environment.
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Hispanics are the fastest growing minority population in the United States today. Providing health information services to Hispanic patients and their family members can be challenging because of diversity. Library staff should be familiar with the specific health care needs and sociocultural characteristics of Hispanics. This article discusses the movement toward providing culturally competent health care and identifies socioeconomic challenges and barriers to health care faced by Hispanics. Suggestions are offered for communicating with this group in the reference setting, and a selective bibliography of Internet consumer health resources available in both Spanish and English is provided. 相似文献
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McGowan JJ 《Bulletin of the Medical Library Association》2000,88(4):355-361
Service to the state is one of the core principles of the land-grant mission. This concept of service is also fundamental to a significant number of outreach activities in academic health sciences libraries, particularly those libraries affiliated with the public land-grant universities. The Dana Medical Library at the University of Vermont has a lengthy tradition of outreach to health care providers and health care consumers of the State of Vermont. Building on the foundation of the land-grant institution-which grew out of federal legislation introduced in the mid nineteenth century by Justin Morrill, Vermont's congressional representative--the Dana Medical Library has based its outreach activities on its dedication of service to the state in the promotion of healthy citizens through information dissemination in support of health care delivery. Reengineering library services designed to meet the specific information needs of its diverse clientele, partnering with disparate health care organizations, and relying on fees for service to expand its outreach activities, the Dana Medical Library has redefined the concept of health information outreach for the new millennium. 相似文献